HomeMy WebLinkAboutContract 62115FORTWORTH CSC No. 62115
CITY OF FORT WORTH
COOPERATIVE PURCHASE AGREEMENT
This Cooperative Purchase Agreement ("Agreement") is entered into by and between Midwest
Library Service, Inc. ("Vendor") and the City of Fort Worth, ("City"), a Texas home -rule municipality,
individually referred to as "party" and collectively as the "parties".
The Cooperative Purchase Agreement includes the following documents which shall be construed in the order of
precedence in which they are listed:
1. This Cooperative Purchase Agreement;
2. Exhibit A — Seller's Quote;
3. Exhibit B — Cooperative Agency Contract TX Smart Buy 715-M2; and
4. Exhibit C — Conflict of Interest Questionnaire
Exhibits A, B, and C, which are attached hereto and incorporated herein, are made a part of this Agreement
for all purposes. Vendor agrees to provide City with the services and goods included in Exhibit A pursuant to the
terms and conditions of this Cooperative Purchase Agreement, including all exhibits thereto. If any provisions of
the attached Exhibits conflict with the terms herein, are prohibited by applicable law, conflict with any applicable
rule, regulation or ordinance of City, the terms in this Cooperative Purchase Agreement shall control.
City shall pay the Vendor in accordance with the fee schedule in Exhibit A and in accordance with the
provisions of this Agreement. Total payment made under this Agreement by City shall not exceed one hundred
thousand dollars ($100,000.00). Vendor shall not provide any additional items or services or bill for expenses
incurred for City not specified by this Agreement unless City requests and approves in writing the additional costs
for such services. City shall not be liable for any additional expenses of Vendor not specified by this Agreement
unless City first approves such expenses in writing.
The term of this Agreement is effective beginning on the date signed by the Assistant City Manager below
("Effective Date") and expires on October 31, 2024 in line with cooperative contract.
Vendor agrees that City shall, until the expiration of three (3) years after final payment under this
Agreement, or the final conclusion of any audit commenced during the said three years, have access to and the
right to examine at reasonable times any directly pertinent books, documents, papers and records, including, but
not limited to, all electronic records, of Vendor involving transactions relating to this Agreement at no additional
cost to City. Vendor agrees that City shall have access during normal working hours to all necessary Vendor
facilities and shall be provided adequate and appropriate work space in order to conduct audits in compliance with
the provisions of this section. City shall give the Vendor reasonable advance notice of intended audits.
This Agreement shall be construed in accordance with the laws of the State of Texas. If any action,
whether real or asserted, at law or in equity, is brought pursuant to this Agreement, venue for such action shall lie
in state courts located in Tarrant County, Texas or the United States District Court for the Northern District of
Texas, Fort Worth Division.
Notices required pursuant to the provisions of this Agreement shall be conclusively determined to have
been delivered when (1) hand -delivered to the other party, its agents, employees, servants, or representatives
received by the other party by United States Mail, registered, return receipt requested, addressed as follows:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
To CITY:
tCfT�LRDIN
City of Fort Worth Midwest Library Service, Inc.
Attn: Jesica McEachern, Assistant City Manager
100 Fort Worth Trail 11443 St. Charles Rock RD
Fort Worth, TX 76102 Bridgeton, Missouri 63044
With a copy to the Fort Worth City Attorney's Office Facsimile: (800) 325-8833
at the same address
Nothing herein constitutes a waiver of City's sovereign immunity. To the extent the exhibits require City
to waive its rights or immunities as a government entity; such provisions are hereby deleted and shall have no
force or effect.
To the extent the exhibits, in any way, limit the liability of Vendor or requires City to indemnify or hold
Vendor or any third party harmless from damages of any kind or character, City objects to these terms and any
such terms are hereby deleted from the Agreement and shall have no force or effect.
City is a government entity under the laws of the State of Texas and all records held or maintained for
City are subject to disclosure under the Texas Public Information Act. In the event there is a request for
information marked Confidential or Proprietary, City will promptly notify Vendor. It will be the responsibility of
Vendor to submit reasons objecting to disclosure to the Texas Attorney General. A determination on whether such
reasons are sufficient will not be decided by City, but by the Office of the Attorney General of the State of Texas
or by a court of competent jurisdiction.
If Vendor has fewer than 10 employees or this Agreement is for less than $100,000, this section does not
apply. Vendor acknowledges that in accordance with Chapter 2271 of the Texas Government Code, the City is
prohibited from entering into a contract with a company for goods or services unless the contract contains a written
verification from the company that it: (1) does not boycott Israel; and (2) will not boycott Israel during the term
of the contract. By signing this Agreement, Vendor certifies that Vendor's signature provides written verification
to the City that Vendor: (1) does not boycott Israel; and (2) will not boycott Israel during the term of the
Agreement.
Vendor acknowledges that in accordance with Chapter 2276 of the Texas Government Code, the City is
prohibited from entering into a contract for goods or services that has a value of $100,000 or more that is to be
paid wholly or partly from public funds of the City with a company with 10 or more full-time employees unless
the contract contains a written verification from the Vendor that it: (1) does not boycott energy companies; and
(2) will not boycott energy companies during the term of this Agreement. To the extent that Chapter 2276 of the
Government Code is applicable to this Agreement, by signing this Agreement, Vendor certifies that Vendor's
signature provides written verification to the City that Vendor: (1) does not boycott energy companies; and (2)
will not boycott energy companies during the term of this Agreement.
Vendor acknowledges that except as otherwise provided by Chapter 2274 of the Texas Government Code,
the City is prohibited from entering into a contract for goods or services that has a value of $100,000 or more that
is to be paid wholly or partly from public funds of the City with a company with 10 or more full-time employees
unless the contract contains a written verification from the Vendor that it: (1) does not have a practice, policy,
guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will not
discriminate during the term of the contract against a firearm entity or firearm trade association. To the extent
that Chapter 2274 of the Government Code is applicable to this Agreement, by signing this Agreement, Vendor
certifies that Vendor's signature provides written verification to the City that Vendor: (1) does not have a practice,
policy, guidance, or directive that discriminates against a firearm entity or firearm trade association; and (2) will
not discriminate against a firearm entity or firearm trade association during the term of this Agreement.
(signature page follows)
The undersigned represents and warrants that he or she has the power and authority to execute this Agreement
and bind the respective party.
CITY OF FORT W TH:
By: cv�
Name: Jesica McEachern
Title: Assistant City Manager
Date: Oct 15, 2024
APPROVAL RECOMMENDED:
. Xf,
By: Midori Clark (Oct 4, 202413:09 CDT)
Name: Midori Clark
Title: Library Director
' f*o Rt�R4rIl
�o°�9.io
ATTEST:
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PPa� oa oo *d
daa� nEoA`,,4pp
By:
Name: Jannette Goodall
Title: City Secretary
LT WL1111-9
Midwest Library Service, Inc.
7-t-Udy Hamol- -
By: Trudy Barrett (Oct 4, 202411:53 CDT)
Name: Trudy Barrett
Title: General Manager
Date: nr� 7�7
CONTRACT COMPLIANCE MANAGER:
By signing I acknowledge that I am the person
responsible for the monitoring and administration of
this contract, including ensuring all performance
and reporting requirements.
By:
April Jacquez (Oct 4, 202412:17 CDT)
Name: April Jacquez
Title: Sr. Contract Compliance Specialist
APPROVED AS TO FORM AND LEGALITY:
.Aitt�.rz2 P/�i�od
By:
Name: Andrea Phillips
Title: Assistant City Attorney
CONTRACT AUTHORIZATION:
M&C: N/A
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
EXHIBIT A
Contract Item List
Contract No. 715M2 Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Midwest Library Service, Inc.
Electronic an(
Category 1
Digital pre -loaded; all -in -one audio books
Category 2
Digital pre -loaded; all -in -one audio book pack kits
Category 3
Digital pre -loaded
Category 4
Audiovisual Pre -loaded; Device included
Print
Category 5
Adult trade; fiction/non-fiction hardbound
Category 6
Adult trade; fiction/non-fiction paperback
Category 7
Juvenile trade; fiction/non-fiction hardbound
Category 8
Juvenile trade; fiction/non-fiction paperback
Category 9
Mass market paperback; rack
Category 10
Non -trade publication; hardbound
Category 11
Non -trade publications; paperback
Category 12
University press
Category 13
Adult library bound; fiction/non-fiction
Category 14
Juvenile library bound; fiction/non-fiction
Category 15
Pre -bound hardbound
Category 16
Pre -bound paperback
Nonstani
Category 17
Music/Audio Compacts Disc; Pre-recorded
Category 18
Music/Audio Record Disc, Vinyl; Pre-recorded
Audiovisual DVD/Blue-ray pre-recorded; feature/non-
Category 19
feature films
Category 20
Spoken word/audio compact disc pre-recorded; abridged
Category 21
Spoken word/audio compact disc pre-recorded; un-abridged
Category 22
Spoken word/audio MP3 format pre-recorded; un-abridged
K-12
School Libraries
Category
Public Libraries
(City, Regional, etc.)
Category
Academic
Institutions
Category
State Agencies and
Co -Op Member
Category
i Digital Materials
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Materials
net - 33%
net - 33%
net - 33%
net - 33%
net - 10%
net - 10%
net - 10%
net - 10%
net - 33%
net - 33%
net - 33%
net - 33%
net - 10%
net - 10%
net - 10%
net - 10%
net -10%
net - 10%
net - 10%
net -10%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net -15%
net - 33%
net - 33%
net - 33%
net - 33%
net-33%
net-33%
net-33%
net-33%
net -10%
net - 10%
net - 10%
net -10%
net - 10%
net - 10%
net - 10%
net - 10%
lard Formats
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
*N/A = not awarded
Contract Item List
Contract No. 715M2 Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Midwest Library Service, Inc.
Premium Processing - Shelf -Ready
Base Price
Description
Mylar Jacket (or Laminate Cover), Label Protectors, Spine
$3.20
Label, Barcode, and Standard MARC Record
Mylar Jacket (or Laminate Cover), Label Protectors, Spine
Label, Barcode, RFID Tag (programmed and applied), and
$3.95
Standard MARC Record
Processing Services
Base Price
Description
Brief MARC Record
No Charge
If Vendor Offers MARC records, a Brief MARC Record Shall Be Free
of Charge, Per the Terms of This RFP
Full MARC Record
Mylar Jacket
Barcode Label
Label (per application -Customer supplied)
Label (per application -Vendor supplied)
Genre Label
Spine Label
Label Protector
Pocket (paper)
Pocket (vinyl)
Property Stamp (per impression)
Spine Tape (inside)
Spine Tape (Outside)
$0.85
$1.05
$0.65
$0.30
$0.50
$0.30
$0.65
$0.25
$0.30
$0.65
$0.35
n/a
n/a
Audio Visual Processing and Accessories
Base Price
Description
Digital Processing for Media
Format Conversion Service
Hub Label (per application)
Shrink Wrap Removal
IDVD/CD Case, Holds Single Disc (Paper)
IDVD/CD Case, Holds Single Disc (Plastic)
IDVD/CD Case, Holds Multiple Discs
IDVD/CD Case, Locking
Spoken Audio CD Case; Various Capacities
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
n/a
Laminated Paperback Covers
Polypropylene Laminate; Various Thicknesses
Vinyl Laminate; Various Thicknesses
Base Price IDescription
$2.20-3.35 ICost dependent on size of book.Hinges $0.75 - $0.95
n/a
RFID/Theft Deterrents
Base Price
Description
Pre-programmed RFID/Barcode Set (1 Barcode); Applied to
book
�RFID ("universal" tag programmed and applied)
jCD/DVD Overlay RFID Tag
Theft Deterrent Tape/Strip
$0.65
$0.75
n/a
$0.55
EXHIBIT B
(https://www.comptrolIer.texas.gov/)
Texas Comptroller of
Public Accounts
Glenn Hegar
TEXAS
BUY
W
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0 items
Contract Details: # 715-M2
Number 715-M2
Description Publications, Audiovisual Materials, Books, Textbooks, and Ancillary Services
Category Managed
Type Term
Start Date 6/29/2020
End Date 10/31/2024
Purchase Category PCC C
Code(Agencies Only)
Optional Renewal Terms No renewal remaining
Purchase Orders Customers will issue an internal purchase order that references this CPA Contract Number and current item
description(s) and pricing as stated on this contract. The Contractor will not ship any products or provide related
services until receipt of a Purchase Order generated by the State Agency, Higher Education or Cooperative
member.
NIGP Code(s) 525-10
525-20
525-40
715-04
715-05
715-10
715-46
715-55
956-10
CPA Contract Questions regarding contract management issues, price changes, amendments or other post -award concerns
Management should be directed to:
SPD Contract Management Office (SCMO)
Texas Comptroller of Public Accounts (CPA)
Phone: (512) 463-3034 option 3
Email: spd.cmo@cpa.texas.gov (mailto:spd.cmo@cpa.texas.gov)
Contract Items and Customers should contact the applicable company representative in order to set up an account.
Pricing
715-M2 Baker & Taylor, LLC Price Sheet (http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20B&T%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Brodart Co. Price Sheet (http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Brodart%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Yankee Book Peddler, Inc. dba GOBI Library Solutions from EBSCO Price Sheet
(http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc. %20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20GOB1%20Library%20Solutions%20from%20EBSCO%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Ingram Library Services LLC Price Sheet
(http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc. %20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%201ngram%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Midwest Library Service, Inc. Price Sheet
(http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc. %20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Midwest%20Library%20Service%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 Midwest Tape, LLC Price Sheet (http://www.txsmarLbuy.com/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20Midwest%20Tape%20TSB%20Contract%201tem%20Listing.pdf)
715-M2 ProQuest, LLC Price Sheet (http://www.txsmartbuy.com/SSP%20Applications/NetSuite%201nc.%20-
%20Shopping/Custom%20ShopFlow/Documents/Contract%20Attachments/715-
M2%20ProQuest%20TSB%20Contract%201tem%20Listing.pdf)
Warranty Details Warranty/Guarantee
Each product proposed is to be warranted against defects in workmanship and material for a period of ninety (90)
days or the duration of the manufacturer's standard warranty, whichever is longer, following Customer's
acceptance. If no time or specific protocol for acceptance is specified elsewhere in the Contract or the Customer
purchase order, items are presumed accepted ten (10) working days after receipt. The warranty will apply to any
warranty service or repair requested by Customer during the warranty period by contacting the Contractor or
Contractor's designee with such request, regardless of the amount of time required to complete the requested
warranty service or repair. It is the intention of the parties to this Contract that Contractor's warranty obligations
hereunder will survive the termination of this Contract.
Replacement
1) Contractor must guarantee replacement of improperly manufactured products due to defective materials or
product during the initial Contract period and any exercised renewal options.
2) Contractor must guarantee replacement or compensation to Customer if Contractor damages Customer's
property when applying ancillary or processing services.
3) The replacements must be processed and received by the Customer within two weeks of written notification.
4) Contractor will provide replacement free of any charge, including any shipping necessary to return the product
when necessary.
5) Contractor will either replace the product with new product or refund the full purchase price of the product,
whichever the Customer prefers.
Adding New Products to Additional products or services of the same general category that are not already on the contract may be added by
the Contract submitting an Open Market Requisition (https://comptroller.texas.gov/purchasing/forms/ ) to the Statewide
Contract Development section at open.market@cpa.texas.gov(mailto:open.market@cpa.texas.gov).
Delivery Delays by If delay is foreseen, Contractor shall give written notice to the Customer and must keep Customer advised at all
Contractor times of status of order.
Default in promised Delivery Days After Receipt of Order (ARO) without accepted reasons or failure to meet
specifications authorizes the Customer to purchase goods and services of this contract elsewhere and charge any
increased costs for the goods and services, including the cost of re -soliciting, to the Contractor.
Failure to pay a damage assessment is cause for contract cancellation and/or debarment or removal of the
contractor, as applicable, from the State's Centralized Master Bidders List (CMBL).
Compliant Products by Delivery does not occur until the Contractor delivers products, materials or services in full compliance with the
Contractor specifications to Customer's F.O.B. destination, unless delivery is specifically accepted, in whole or in part, by the
Customer. Providing products, materials or services which do not meet all specification requirements does not
constitute delivery.
Customer reserves the right to require new delivery or a refund in the event that materials or products not meeting
specifications are discovered after payment has been made.
Purchase Order
The Customer may request that a Contractor cancel a specific line item or an entire purchase order. There shall
Cancellation
be no fees charged for cancellation of an item and/or order prior to shipment by the Contractor. A Purchase Order
Change Notice should be processed and sent to Contractor.
Restocking Fee for
The Customer may request that a Contractor accept return of products already delivered. If the return is required
Returned Products
through no fault of the Contractor, the Contractor may request a reasonable restocking charge. The Customer may
pay a restocking charge if the CPA or Customer determines that the charge is justifiable. As a guideline, such
charges shall not exceed 10% for contractors.
Substitutions
During the Contract term, the Contractor shall not substitute a product or brand unless the Contractor has
obtained prior written approval from the CPA Contract Manager in coordination with the Customer. The Contractor
must have written confirmation from the CPA Contract Manager of the substitution before making delivery.
Contractor Performance
The Statewide Procurement Division Contract Management Office (SCMO), a division of the Comptroller of Public
Accounts (CPA), administers a vendor performance program for use by all customers per Texas Government
Code (TGC), §2262.055, and 34 Texas Administrative Code JAC), §20.108. The Vendor Performance relies on
the customer's participation in gathering information on vendor performance. State agency customers shall report
vendor performance on purchases of $25,000 or more from contracts administered by CPA, or any other purchase
of $25,000 or more made through delegated authority granted by CPA JAC 20.108), or purchases exempt from
CPA procurement rules and procedures. State agencies are additionally encouraged to report vendor performance
on purchases under $25,000.
Vendor Performance shall be reported through the CPA VENDOR PERFORMANCE TRACKING SYSTEM
(https://www.comptroller.texas.gov/purchasing/programs/vendor-performance-tracking/).
The purpose of the Vendor Performance Tracking System is to:
• Identify vendors that have exceptional performance
• Aid purchasers in making a best value determination based on vendor past performance
• Protect the state from vendors with unethical business practices
• Track vendor performance for delegated and exempt purchases
Contractors Information
VID:14731799749
Contractor: Baker & Taylor, LLC
Contact Name: Wendy Hardy
Email: wendy.hardy@baker-taylor.com
Phone: (800) 775-1200 x2776
Alternate Contact Name: Stefanie Kremer
Alternate Email: stefanie.kremer@baker-taylor.com
Alternate Phone: (704) 998-3135
Address: 2810 Coliseum Centre Drive Suite 300 Charlotte, NC 28217
VID:12322487583
Contractor: Brodart Co.
Contact Name: Mary Miller
Email: mary.miller@brodart.com
Phone: (800) 233-8467
Alternate Contact Name: Lisa Miosi
Alternate Email: lisa.miosi@brodart.com
Address: 500 Arch Street Williamsport, PA 17701
VID:16217466966
Contractor: Ingram Library Services LLC
Contact Name: Stephen Casey
Email: stephen.casey@ingramcontent.com
Phone: (214) 952-6310
Alternate Email: ils.orders@ingramcontent.com
Address: One Ingram Blvd. La Vergne,TN 37086
VID:14308345058
Contractor: Midwest Library Service, Inc.
Contact Name: Trish Banta
Email: banta@midwestls.com
Phone: (800) 325-8833
Alternate Contact Name: Herbert Lesser
Alternate Email: hlesser@midwestls.com
Address: 11443 St. Charles Rock Rd. Bridgeton, Missouri 63044
VID:13714996868
Contractor: Midwest Tape, LLC
Contact Name: Janet Timm
Email: jtimm@midwesttape.com
Phone: (800) 875-2785
Alternate Contact Name: Jeffery Jankowski
Alternate Email: jankowski@midwesttape.com
Alternate Phone: (419) 868-9370
Address: PO Box 820 Holland, OH 43528
VID:13920538553
Contractor: ProQuest, LLC
Contact Name: Jess Snyder
Email: Proposals@proquest.com
Phone: (248) 496-1065
Address: Proquest, LLC 789 E. Eisenhower Parkway Ann Arbor, MI 48106
VID:10203021430
Contractor: Yankee Book Peddler, Inc. dba GOBI Library Solutions from EBSCO
Contact Name: Bonnie LaRose
Email: bidadmin@ybp.com
Phone: (800) 258-3774 x8895
Alternate Contact Name: Kate Hartnett
Alternate Email: khartnett@ybp.com
Alternate Phone: (800) 258-3774 x8808
Address: 999 Maple Street Contoocook, NH 02339
Texas Comptroller of Public Accounts
Glenn Hegar
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Exhibit C - Conflict of Interest Questionnaire
CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ
For vendor doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICE USE ONLY
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received
has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the
vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local governmental entity not later
than the 7th business day after the date the vendor becomes aware of facts that require the statement to be
filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An
offense under this section is a misdemeanor.
jJ Name of vendor who has a business relationship with local governmental entity.
J
❑ Check this box if you are filing an update to a previously filed questionnaire. (The law requires that you file an updated
completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which
you became aware that the originally filed questionnaire was incomplete or inaccurate.)
J Name of local government officer about whom the information is being disclosed.
City of Fort Worth
Name of Officer
J Describe each employment or other business relationship with the local government officer, or a family member of the
officer, as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer.
Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form
CIO as necessary.
N/A
A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income,
other than investment income, from the vendor?
Yes F-1 No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction
of the local government officer or a family member of the officer AND the taxable income is not received from the
local governmental entity?
71 Yes F1 No
J Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or
other business entity with respect to which the local government officer serves as an officer or director, or holds an
ownership interest of one percent or more.
N/A
J
❑Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts
as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1).
J
Trudy Barrei-f Oct 4, 2024
Trudy Barrett (Oct4, 202411:53 CDT)
Signature of vendor doing business with the governmental entity Date
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
CONFLICT OF INTEREST QUESTIONNAIRE
For vendor doing business with local governmental entity
Acomplete copy of Chapter 176 of the Local Government Code maybe found at http://www.statutes.legis.state.tx.us/
Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form.
Local Government Code § 176.0010-a): "Business relationship" means a connection between two or more parties
based on commercial activity of one of the parties. The term does not include a connection based on:
(A) a transaction that is subject to rate or fee regulation by a federal, state, or local governmental entity or an
agency of a federal, state, or local governmental entity;
(B) a transaction conducted at a price and subject to terms available to the public; or
(C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and
that is subject to regular examination by, and reporting to, that agency.
Local Government Code § 176.003(a)(2)(A) and (B):
(a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if:
(2) the vendor:
(A) has an employment or other business relationship with the local government officer or a
family member of the officer that results in the officer or family member receiving taxable
income, other than investment income, that exceeds $2,500 during the 12-month period
preceding the date that the officer becomes aware that
(i) a contract between the local governmental entity and vendor has been executed;
or
(ii) the local governmental entity is considering entering into a contract with the
vendor;
(B) has given to the local government officer or a family member of the officer one or more gifts
that have an aggregate value of more than $100 in the 12-month period preceding the date the
officer becomes aware that:
(i) a contract between the local governmental entity and vendor has been executed; or
(ii) the local governmental entity is considering entering into a contract with the vendor.
Local Government Code § 176.006(a) and (a-1)
(a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship
with a local governmental entity and:
(1) has an employment or other business relationship with a local government officer of that local
governmental entity, or a family member of the officer, described by Section 176.003(a)(2)(A);
(2) has given a local government officer of that local governmental entity, or a family member of the
officer, one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B), excluding any
gift described by Section 176.003(a-1); or
(3) has a family relationship with a local government officer of that local governmental entity.
(a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator
not later than the seventh business day after the later of:
(1) the date that the vendor:
(A) begins discussions or negotiations to enter into a contract with the local governmental
entity; or
(B) submits to the local governmental entity an application, response to a request for proposals
or bids, correspondence, or another writing related to a potential contract with the local
governmental entity; or
(2) the date the vendor becomes aware:
(A) of an employment or other business relationship with a local government officer, or a
family member of the officer, described by Subsection (a);
(B) that the vendor has given one or more gifts described by Subsection (a); or
(C) of a family relationship with a local government officer.
Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 1/1/2021
Signature: Keay
Signature:5�
Email: Katherine.Cenicola@fortworthtexas.gov Email: allison.tidwell@fortworthtexas.gov